Correlation between serum hepatitis B virus DNA replication level and clinicopathology in 235 patients with hepatitis B associated glomerulonephritis

Objective: To explore the correlation between serum hepatitis B virus (HBV-DNA) replication levels and clinicopathology in patients with HBV-associated glomerulonephritis (HBV-GN). Methods: A total of 235 patients with HBV-GN were divided into 4 groups, according to the serum titer of HBV-DNA: the viral replication negative group (n = 85), the low-level replication group (n = 35), the moderate-level replication group (n = 38), and the high-level replication group (n = 77). The results of routine blood examination, blood biochemistry, immune globulin, serum complement components C3 and C4, routine urine examination, 24-h urine protein, and other measurements were obtained. The differences between the clinical and pathological manifestations of the different viral replication groups were analyzed by semi-quantitative integration. Results: With increasing serum HBV-DNA level, urinary protein excretion was increased, while albumin in plasma and C3 and C4 in serum were decreased. The differences were statistically significant (P<0.05). In addition, with increasing serum HBV-DNA levels, glomerular injury was aggravated in patients with a pathological type of membranous nephropathy, and tubulointerstitial damage became worse in patients with pathological types of IgA nephropathy. There was no significant difference in the degree of pathological HBV markers deposited in renal tissues among the groups with different levels of HBV-DNA replication. Additionally, the serum HBV-DNA level was positively correlated with C4 deposition in renal tissues. Conclusion: With increasing serum HBV-DNA replication levels, clinical and renal pathological manifestations were aggravated in HBV-GN patients.